![]() Ischemic infarctions of these small vessels lead to small round infarctions called lacunae, which are scattered throughout the brainstem. Small vessels are affected by lipohyalinosis, which is closely associated with hypertension. However, the pathology of small vessel disease differs from that of large vessels, which atherosclerosis affects. Ītherosclerosis is the most common condition affecting the vertebrobasilar system, in which atheromatous plaques narrow and occlude large vessels. The most common mechanism of occlusion of the vertebral artery or PICA is atherothrombosis. Most (80%) cases are caused by occlusion of the vertebral artery, which gives rise to the PICA and the anterior spinal artery before it joins with the opposite vertebral artery to form the basilar artery. It turns out that occlusion of the PICA accounts for only a small number of cases. Anatomically the infarcted area in Wallenberg syndrome is supplied by the posterior inferior cerebellar artery (PICA). The syndrome can also be due to occlusion of the vertebral artery or the inferior, middle, or superior medullary vessels. The primary pathology of Wallenberg syndrome is occlusion of the posterior inferior cerebellar artery (PICA) or one of its branches. ![]() The trunk of PICA is divided into five segments: The fourth segment of the vertebral artery gives off the PICA, the largest branch of the vertebral artery. The vertebral artery, arising from the subclavian artery, is classically divided into four segments. ![]() The posterior inferior cerebellar artery (PICA) usually originates from the vertebral artery at an average distance of approximately 16 or 17 mm below the vertebrobasilar junction. This neurological disorder is associated with various symptoms that result from damage to the lateral segment of the medulla posterior to the inferior olivary nucleus. Wallenberg syndrome is also called lateral medullary or posterior inferior cerebellar artery syndrome. However, a more detailed description given in 1895 by Adolf Wallenberg identified this condition as infarction of the lateral medulla oblongata following occlusion of the vertebral artery (VA) or Posterior inferior cerebellar artery (PICA). Wallenberg syndrome was first described in 1808 by Gaspard Vieusseux.
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